Method and apparatus for health and disease management combining patient data monitoring with wireless internet connectivity

ABSTRACT

Embodiments of the invention provide a method and apparatus for a wireless health monitoring system for interactively monitoring a disease or health condition of a patient by connecting an internet-enabled wireless web device (“WWD”) to a health monitoring device which may be a medical device or other health related device such as an exercise machine. The WWD may be connected to the health monitoring device directly by a wired connection to a generic input/output port of the WWD using an optional adaptor if necessary. Alternatively, the WWD may be wirelessly connected to the health monitoring device, such as via an infrared or radio frequency connection, including using protocols such as Bluetooth or 802.11. The wireless connection may also employ an adaptor if necessary. The user may also input data to the WWD manually, such as by a keypad, keyboard, stylus, or optionally by voice command. The health related data is transmitted from the WWD to a server using standard internet protocols. The server calculates a response using a software program which may include an algorithm or artificial intelligence system, and may further provide for review by a physician or health specialist. The user may interact with the server. For example, the server transmits a response to the WWD, and the user may answer the response or provide other information.

CROSS-REFERENCE TO RELATED APPLICATIONS

This is a continuation of U.S. patent application Ser. No. 11/184,274,filed Jul. 18, 2005, entitled “Method and Apparatus for Health andDisease Management Combining Patient Data Monitoring with WirelessInternet Connectivity,” now U.S. Pat. No. 7,156,808, which is acontinuation of U.S. patent application Ser. No. 10/418,845, filed Apr.18, 2003, now U.S. Pat. No. 6,936,007, which is a continuation of U.S.patent application Ser. No. 09/738,270, filed Dec. 15, 2000, now U.S.Pat. No. 6,602,191, which is a conversion of U.S. ProvisionalApplication Ser. No. 60/172,486, filed Dec. 17, 1999. The disclosure ofeach of the prior applications is incorporated herein by reference inits entirety.

REFERENCE TO GOVERNMENTAL SUPPORT

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REFERENCE TO MICROFICHE APPENDIX

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FIELD OF THE INVENTION

The present invention relates to monitoring of living subjects, and moreparticularly to health-monitoring of persons where measured or inputhealth data is communicated by a wireless device to and from a softwareapplication running on an internet-connected server and where the samemay be studied and processed by the software application, a healthprofessional, or the subject.

BACKGROUND OF THE INVENTION

Several attempts have been made in the past to achieve efficientinteractive communication of medical or health information between asubject or patient and a reviewer or provider of that information. Inparticular, communication of consumer physiological information has beena subject of such attempts. It is noted that in this regard the“reviewer or provider of medical or health information” is understood toinclude not only a physician but also a software application oralgorithm that may analyze the information.

Medical or health information has been made available on a D-ROMaccessible by a home computer system. This passive approach had certaindisadvantages. First, although the personal computer is prevalent is theUnited States, it is generally too expensive for a consumerphysiological monitoring system and there are many people who find ittoo complicated to set up and use for that purpose. High-risk,chronically ill patients, responsible for more than half of health carecosts in the United States and forming the fastest growing segment ofthose requiring health care, are indeed the most likely not to be ableto afford or use a system built around a personal computer. In addition,such systems are limited in their interactivity to the informationstored on the CD.

Previous patents by the Inventor addressed both of these disadvantages,as well as the need to reduce health care costs through providingeducational health care information and interactive physiologicalmonitoring in the home environment by means of a user-friendly,interactive system (see, e.g., U.S. Pat. Nos. 5,601,435, 6,144,837, andcontinuations thereof).

These previous patents were based on a video game console, or amultimedia player using a conventional television screen as the displaydevice to achieve a system which is simpler to use than systems based ona personal computer. An initial embodiment of the previous patentsutilized a compact disc to provide interactive information for diseasemanagement.

Even with the advantages provided, these systems limited the user tolocation in which the device was located. Even where devices areportable, as in the case of a laptop computer with a modem, an ordinaryPOTS phone line must be found and used. Where the user's computeremploys a broadband connection, such as DSL or satellite, the choices oflocation are even more limited.

Attempts have been made to remedy this deficiency. For example, manytelemetry systems allow a “wireless” distance to be placed between ahealth measuring unit and a remote monitoring system. However, suchsystems are limited in their range.

Other systems have used cellular telephone technology to increase thewireless health monitoring range. However, these systems have severaldeficiencies, such as requiring significant modification of the mobilephone. For example, U.S. Pat. No. 5,772,586, issued Jun. 30, 1998 toHeinonon et al., discloses a method for monitoring the health of apatient. This system uses a specialized connection between the patienthealth measuring unit and the cellular phone, however. The patienthealth measuring unit is located in the battery space of the mobilephone and is connected to a communication bus of the mobile phone. Othersystems have been proposed, but these suffer from similar deficienciesin that they are not designed to be used with “off-the-shelf” wirelessdevices or health measuring equipment.

The deployment of the above systems also currently lacks employment offull back-end server functionality with which to provide a wide range ofinteractive communication with the patient. Instead, such systems, ifinternet-enabled, are often limited to mere one-way non-interactive datatransfer via a modem. While some systems are more enhanced, includingthat disclosed in U.S. Pat. No. 5,357,427, issued Oct. 18, 1994 toLangen, et al., and entitled “Remote Monitoring of High-Risk Patientsusing Artificial Intelligence”, these systems are limited by the wiredtelecommunications infrastructure.

SUMMARY OF THE INVENTION

Embodiments of the present invention overcome one or more of thedisadvantages of the prior art by providing a full-featurehealth-monitoring system that may wirelessly connect to a back-endserver application via the internet. The invention allows wirelessaccess to and from a wide variety of present medical or health-relatedinstruments and devices, while maintaining the capability of connectingto future such devices.

In particular, the invention may be embodied in several systems. Twocomplementary such systems are described herein, although extensions toother such systems can be envisioned. First, an embodiment of theinvention may be employed to manage the disease state or condition of apatient. In this embodiment, the patient may employ a health monitoringdevice (“HMD”), in particular a medical device, and a wirelessconnection provides data from the medical device for processing via theinternet including a review by a physician or other health careprofessional if required.

In the second embodiment, a health or lifestyle management plan may beimplemented. Various health parameters, such as those relating tonutrition or exercise, may be entered into a health monitoring device,in this instance termed an “exercise machine”, and the same may bewireless communicated to a server. An application may process and storethe health parameters, and a health specialist may optionally review thesame.

Wireless internet connectivity has many advantages. For example, in thefirst embodiment, a diabetic could connect a blood glucose meter to aninternet-enabled wireless web device (“WWD”) away from home and downloaddata to a Diabetes Management Company's server and, in response, receiveguidance displayed on the screen (or by voice) about choices for thenext meal.

Alternatively, in the second embodiment, a person interested in trackingan exercise program may take the WWD to the local health club and attachthe same to an exercise machine, send data output from various exercisemachines over the Internet, and receive a personalized response from theserver of a company specializing in Health & Lifestyle Management. Theindividual may input caloric content of foods eaten, and may furtherinput caloric content of exercise performed. In this way, e.g., a personin a weight-loss program may see in great detail whether they areexpending more calories in the form of exercise than the same individualis consuming in the form of food.

In general, in the health management embodiment, the system may beemployed to monitor the physiologic status of a healthy subject whileeating, exercising, or performing other activities. For clarity, suchdevices are termed herein “exercise machines”. These may include anelectronic body weight scale, a body fat gauge, biofeedback devices,physiotherapy or chiropractic equipment, blood pressure recorders, orthe like, or any type of exercise machine or monitor, including a heartrate monitor, treadmill, rowing machine, stepper, or the like.

In more detail, the present invention provides a method and system forassisting patients to manage a disease or maintain healthy lifestyle bycollecting health-related data and providing information in response tothose data by means of a WWD designed to display interactive informationthrough a connection to the Internet. The present invention may beconnected to various HMDs, both medical and exercise-related in nature,and may communicate information via a wireless connection such as awireless Internet connection.

A major advantage of embodiments of the invention is that the same freesthe patient from the constraints of wired systems. The same allows userswith consumer “off-the-shelf” wireless devices to significantly extendthe range of connectivity over that of wired computer, television, oreven wireless telemetry systems.

In a first embodiment of the present invention, the WWD is a web-enabledcellular phone. Here it is noted that the term “web” or “internet” areused interchangeably to refer to the internet in general. In a secondembodiment, the WWD is a palm, handheld, or laptop computer, or a PDA,equipped with a wireless modem. In a third embodiment, the WWD may be ahybrid device that combines the functions of a computer, PDA andtelephone.

An adaptor is used if necessary to convert the output signal of themedical monitoring device to a suitable input signal for the WWD. Theadaptor allows connection of the WWD to a medical device, exercisemachine or other variety of health care equipment, and the connectionmay be made via several techniques. As for wired techniques, a standardparallel bus or serial cable may be used if the input/output portsbetween the HMD and the WWD are appropriate. Otherwise, a suitableseparate adaptor may be employed.

The connection may also be an input such as a disk drive or other mediainput for input of data, a USB port or phone jack or other such wiredinput, again employing an adaptor if required.

As for wireless techniques, infrared (IR), microwaves, radio frequency(RF), e.g., Bluetooth® or 802.11 protocols, optical techniques includinglasers, and other such techniques may be used. The patient or subjectmay also input data manually, such as by a stylus, keypad,synchronization from a PC, or by various other techniques discussedbelow.

A major advantage of the invention is that by use of an optionaladaptor, the system is compatible with current and prior HMDs as well asmaintaining a capability of adapting to future such systems.

Other advantages of the invention may include one or more of thefollowing. An embodiment of the invention may be used when a patient istraveling or otherwise away from their “wired” means of communication.The invention allows wireless health-monitoring to the level of accuracypreviously achieved only by desktop so-called “wired” computer systems.The invention is protocol-independent.

The interaction between a WWD and a back-end server may provide a majoradditional advantage in certain embodiments of the invention. Inparticular, the relatively small amount of memory currently provided ona WWD as compared to a back-end server severely limits the functionalityof applications running on the WWD, especially in terms of computingcapacity, processing power, and user interface. By providing significantapplication functionality on the back-end, less memory and processingcapabilities become necessary on the WWD (i.e., on the “front-end”).Thus, memory may be used in the WWD for an enhanced user interface orfor other purposes, according to the user requirements.

In a method according to an embodiment of the invention, the patientconnects to a specific Internet site and a software program, resident ona remote server located on the Internet, downloads an interactive userinterface for that patient and an application for the measurement of thephysiological data. The software may also be downloaded to the WWD froma personal computer via a synchronization operation in known fashion.The software provides a personalized display for the user and configuresthe WWD to control and monitor devices connected via a genericinput/output port to the WWD. The software may be designed to suit theconstraints of the small display screens of WWDs. The software, as wellas inputs from the patient or other inputs, can control the manner,content, and display of information presented to the patient, andmeasured or input data can be stored for review by a health careprovider or by a software algorithm or application. The algorithm may beof varying complexity, from a simple program that merely acknowledgesreceipt of information to an artificial intelligence algorithm, such asan expert system, collaborative filtering system, rules based system,case-based reasoning system, or other such artificial intelligenceapplication.

Further information may be provided to or from the patient, includinginformation entered manually. The patient may input this information viaa personal computer, which then may download the input information tothe WWD via a synchronization operation using standard protocols, suchas those for Palm PDA devices.

The user may also input supplemental information via a PC connectedindependently to the server via the internet. Such supplementalinformation may include data that is difficult or inconvenient to inputon the WWD. In this way, the patient may be afforded a more convenientenvironment in which to manipulate data to supplement the data input tothe WWD. The deployment of voice processing technology may be used toenable an even more convenient user interface: i.e., one to whichpatients can talk.

In all of these respects, the portable aspect of the WWD is important:to with, the user may conveniently carry the WWD on their personwherever they may go, allowing data entry at the time needed.

Other aspects, features, and advantages will be apparent from thesummary above, as well as from the description that follows, includingthe figures and the claims.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 illustrates a general embodiment of a wireless health-monitoringsystem according to the present invention;

FIG. 2 illustrates an embodiment of a wireless health-monitoringapparatus according to the present invention, showing the system of FIG.1 up to a point of a wireless antenna;

FIG. 3 illustrates an embodiment of a back end of a health-monitoringsystem according to the present invention;

FIG. 4 illustrates a data flow diagram according to an embodiment of thepresent invention;

FIG. 5 illustrates an embodiment of a method of use for a wirelessapplication and a server application according to the present invention,in which the same is implemented for disease and patient management;

FIG. 6 illustrates an embodiment of a method of use for a wirelessapplication and a server application according to the present invention,in which the same is implemented for health management;

FIG. 7 illustrates an embodiment of a wired connection between a HMD anda WWD, also showing an optional adaptor; and

FIG. 8 illustrates an embodiment of a wireless connection between a HMDand a WWD, also showing an optional adaptor.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

Various acronyms are used for clarity herein. Definitions are givenbelow.

The term “HMD” may encompass not only devices with physiologic sensorsbut also devices with a keypad, keyboard, mouse, pointer, pressuresensor, or other such inputs that the patient or user may employ toperform data entry of the desired parameters. In general, HMDs includesome means for determining a health parameter.

In a disease management embodiment, an HMD may be a blood glucosemonitor, a blood pressure monitor, an ambulatory ECG recorder, arespiratory monitor, a temperature or heart rate monitor, and so on.

In a healthy lifestyle management embodiment, an HMD may be an exercisemachine, including treadmills, rowers, steppers, exercise cycles, orother aerobic or anaerobic exercisers, or a monitor, include monitorsfor temperature, heart rate, blood pressure, amount of work or rate ofwork performed, etc.

The term “subject” as used herein primarily indicates a human subject.The same may be a medical patient under physician care, a personinterested in maintaining health via accurate recording of nutrition andexercise, and so on. The term “user” is generally used to refer to theuser of the device, which may be synonymous with the subject or mayalternatively be a caregiver of the subject, etc. The term “patient” isused, in addition to a person under the care of a physician, to alsorefer to a “normal” or healthy individual who is interested inmaintaining a healthy physiologic balance.

The term “signal communication” is used to mean any type of connectionbetween components where the connection is, e.g., electromagnetic, andwhere the connection allows information to be passed from one componentto another. This term may be used in a similar fashion as “coupled”,“connected”, “information communication”, “data communication”, etc. Thefollowing are examples of signal communication schemes. As for wiredtechniques, a standard bus or serial cable may be used if theinput/output ports are compatible and an optional adaptor may beemployed if they are not. As for wireless techniques, IR, microwaves,RF, e.g., Bluetooth® or 802.11 protocols, optical techniques includinglasers, and other such techniques may be used. The patient or subjectmay even input data manually, such as by a stylus or keypad or byvarious other techniques discussed above and below.

The term “generic input/output port” is used to mean any type ofconvention, standard, universal, stock, consumer, or “off-the-shelf”type of port for data input and output. These may include both wired andwireless ports. A further description is given below.

Various embodiments of the invention are now described in more detail.

Referring to FIG. 1, a system of the present invention is shown formonitoring health data from a patient or subject 38. The system includesa wireless health-monitoring apparatus (“WHMA”) 10 described in furtherdetail below. WHMA 10 is linked in a wireless fashion to a wirelessconnection point of presence (“POP”) 19, the same including at least abase station antenna 15 coupled to a server 17. Server 17 is in turnconnected to the wired, or even a wireless (not shown) Internet 21,which may include the World Wide Web.

Referring to FIG. 2, an first embodiment of WHMA 10 is shown. WHMA 10includes an HMD 11, which may include an optional monitor screen 40,coupled via an optional adaptor 42 to a WWD 12. WWD 12 connectswirelessly via an antenna 60 to base station 15 (see FIG. 1). Onefunction of WWD 12 is to provide the user interface; other functions aredescribed below.

As noted above, HMD 11 may include a physiologic sensor 24 or mayinclude a manual system 36 for input of physiologic data via aconnection 34. Manual system 36 may also be used to input data directlyinto WWD 12 via a connection 32. Manual system 36 may include, e.g., akeyboard 30, a mouse 26, a pen-type device 28, and may also employ aseparate monitor (not shown). Of course, the user may also viewinformation on monitor 40 or on a screen 41 of WWD 12. In manyembodiments, the stylus-based system employed by many current PDA's,such as the Palm®, may be preferred for such manual data input.

Data may also be input via entry on a computer 37. This data may then besynchronized to WWD 12 in known fashion. Alternatively, computer 37, oranother computer (see computer 37′ in FIG. 4) may be used to connect toa server using the wired internet. This use may be particularlyadvantageous when entering a large amount of data, such as a patient'smedical history. As noted above, in this way the patient may be affordeda more convenient environment in which to manipulate data to supplementthe data input to the WWD.

It will be clear to one of skill in the art given this teaching thatcable 32, as well as cables 34 and 44, may be replaced with wirelesscircuitry to communicate signals wirelessly.

For medical devices and applications, physiologic sensor 24 may include,e.g., a sensor appropriate for measuring blood glucose levels, bloodpressure, heart rate, or any other desired parameter as required by thephysician. Sensor 24 may connect via an optional cable 44 to subject 38.Alternatively, sensor 24 may be distal of HMD 11, i.e., at or withinsubject 38. In other words, if cable 44 is employed, sensor 24 may beproximal or distal of cable 44. If a wireless communications capabilityis added, sensor 24 need not physically connect with HMD 11 or WWD 12 atall. That is, the same may measure a health parameter and maycommunicate the same to wireless health-monitoring apparatus 10wirelessly. The short range wireless communications schemes which may beemployed include infrared, radio frequency including Bluetooth or802.11, or other such schemes.

As examples of sensor types, to measure blood glucose levels, sensor 24may be a sensor that accepts a drop of blood, e.g., via a finger-prick.To measure heart rate, sensor 24 may be placed via an adhesive sensordisposed on the chest. Other health monitors may also be employed solong as the measured data may either be transferred to WWD 12, e.g., viaoptional adaptor 42, described in further detail below, or by being readby a user, e.g., from a display, and manually input to WWD 12.Alternatively, the measured data may be transferred to WWD 12 viawireless communication schemes, such as RF includes Bluetooth® or802.11, infrared, optical, microwaves, etc., directly from sensor 24 orfrom HMD 11 as described in greater detail below.

The user, who may or may not be the same person as subject 38, may inputdata to WWD 12 from history or experience. For example, in a health orexercise device, if subject 38 consumes a known number of calories, thisinformation may be entered via manual system 36 directly into WWD 12 orinto HMD 11. Further, the user, the subject, and the sensor are notnecessarily the sole sources of information. Data stored on the server,or on a separate server operated for health management may also beemployed to result in a health benefit to subject 38.

Referring to FIG. 3, WHMA 10 is shown communicating wirelessly with theInternet. In doing so, WHMA 10 generally sends a wireless signal to abase station 14 (in known fashion) that is connected to a server 18 thatis in signal communication (in known fashion) with the internet. Server18 communicates via a protocol (in known fashion) to Internet 20, whichalso communicates via a protocol (in known fashion) to a server 22running an application 62. Server 22 may be accessed (in known fashion)by a client computer 44 through a connection 64.

As noted, the protocols for data communication are known. However, theycurrently vary amongst known techniques. The present invention is notlimited to any particular protocols, and may be implemented in anylanguages supported by the WWD and server. Of course, as computingcapabilities continue to increase, it is expected that the capabilitiesof WHMA 10, servers 18 and 22, as well as application 62 and client 44,and other components, will correspondingly increase.

Application 62 running on server 22 may interact with WHMA 10 in anumber of ways. Referring to FIG. 4, WHMA 10 is shown in signalcommunication with server 22 via a connection 72. Connection 72schematically represents the wireless Internet connection andintervening pathways. WHMA 10 includes an application that may be viewedas having two components: a base wireless or device application 70 andan application presentation layer or user interface 68. User interface68 is employed to, e.g., present a menu of options to the user, to allowthe user to choose inputs, and to generally operate the device. Userinterface 68 may vary widely in sophistication, e.g., from a simple dataentry field to a full graphical user interface. These applications mayaccept as inputs data from a sensor 24 as well as from a manual input36.

Server 22 has a base server application 62 with which the samecalculates or provides a response based at least in part on data fromWHMA 10. Application 62 may include an algorithm 63 for analyzing datafrom the HMD, and either application 62 or algorithm 63 may optionallyaccess data from an external data source 74 and may further consult anartificial intelligence system 76.

External data source 74 may be a memory or disk or other such storagethat stores health data, such as healthy and unhealthy weight/heightranges, healthy and unhealthy cholesterol counts, the patient's orsubject's prior medical or health history, healthy and unhealthy bloodpressure values, information corresponding to the caloric and othernutritional content of foods, information corresponding to the caloricexpenditure values of various exercises, algorithms for calculatingvarious health parameters, etc. In general, any data that may benefitthe health of a subject or patient may be stored in external data source74. External data source 74 may also include online access of healthinformation from external web sites, ftp servers, or other sources.

Due to the current relatively small amount of memory and storageavailable on current WWDs, such external application processing as byapplication 62 and external data storage as by external data 74 may beparticularly important.

As noted, application 62 or algorithm 63 may also consult AI system 76for suggestions as to health benefits. AI system 76 may even interactwith external data source 74 to extract useful information from thesame. AI system 76 may employ, e.g., case-based reasoning, rules-basedsystems, collaborative filtering, neural networks, expert systems, orother such systems as are known.

It should also be noted that each of application 62, algorithm 63,external data source 74, or AI system 76, may physically reside on morethan one server, e.g., on an array of servers for, e.g., storage ormultiple processing purposes. Each of application 62, algorithm 63,external data source 74, or AI system 76, or combinations of each, mayalso respectively reside on different servers.

The extent to which server application 62 interacts with wirelessapplication 70 depends on the use to which the system is put. Forexample, in a less interactive embodiment, device application 70 may actto measure a diabetic patient's blood glucose level and report the sameto server application 62. In this case, a physician may simply reviewthe measured value and send the patient an email reporting that thevalue is acceptable or not. In a highly interactive embodiment, apatient may have numerous HMDs 11 connected via optional adaptors to aWWD 12, and wireless application 70 may correspondingly send a largeamount of health data to server application 62. The physician, accessingserver application 62, may in turn send detailed care plans to acaregiver via connection 72. The received data may be analyzed usingalgorithm 63, external data source 74, and AI system 76. In this sense,the two applications may be highly interactive.

It is noted that an Application Service Provider (ASP) may operateapplication 62. That is, application 62 may be leased by an ASP to thehealth care provider, and the ASP may perform all necessary upgrades andmaintenance to application 62 and its associated components.

To initialize the system, the program starts and a wireless applicationis loaded into the WWD. The loading of the wireless application mayoccur via synchronization from a desktop or via downloading from aserver over the internet. The server application may be loaded into anappropriate internet-connected server. Subject data may be loaded intothe WWD or into the server. In the latter case, the subject informationmay later be transferred to the WWD or transferred to the server fromthe WWD, as called for by the application. The initialization schemethen ends.

The wireless application may access the server and server application,or vice-versa, as determined by the respective program instructions.Examples are now given for (1) a system of disease and patientmanagement and (2) a system for health management employing an exercisemachine.

Example Employing System for Disease Management

Referring to FIG. 5, an example is given for a system of disease andpatient management. In this figure, as well as in FIG. 6, boxes indotted lines may generally be considered optional.

In FIG. 5, a medical device may determine health parameters and anoptional physician review is provided. Health parameters may also bedetermined by user manual input.

The program is started (step 142) and a sensor measures a healthparameter (step 116). The sensor may send the parameter to a medicaldevice (step 118). The medical device then sends the parameter to theWWD (step 120). The WWD then wirelessly communicates the parameter tothe application server (step 122), e.g., via the wireless web. Theapplication server processes the parameter (step 124), and calculates orprovides a response (step 126) based at least in part on the parameter.The application server may optionally employ algorithm 63 (step 125),external data (step 132) or an AI system (step 134) in the calculation.The application server then sends the response to the WWD (step 128),where the response is displayed (step 130).

It should be noted that the term “response” here is used generally maysimply be an acknowledgement that the parameter was received by theapplication server. The term “calculate” is also used generally, and mayentail a simple calculation as well as a complex one. A result may,e.g., be the result of a calculation.

As noted above, the sensor may connect to any type of medical device orother such device in which information pertaining to a patient's diseaseor condition may be ascertained. The parameter may be any valuecorresponding to such information.

The method may also use a manual input as shown. In this case, after thestart (step 142) of the application, the user may interact with the WWD(step 140). The interact may be a data input, a command to read datafrom a medical device, a response to a physician question or statement,an acknowledgement of physician notification, etc. Calculations by theapplication server may further take into account supplemental data sentby the user to the server, e.g., in a wired fashion directly over theinternet (step 141).

FIG. 5 also shows a physician review and notification. In this option,the responses are displayed on a client computer (step 136) in signalcommunication with the application server. A physician may then reviewthe response on the client computer, and notify the patient of theresponses (step 138). For example, the physician may notify the patientof positive or negative responses. Of course, it should be noted thatthe “client computer” may simply be a pager, PDA, WWD, or other suchdevice, as well as a more typical desktop or laptop computer.

In one implementation, a diabetic may keep a database on a server of adietary history and a blood glucose history. With this data at-handwirelessly, the diabetic may choose whether to eat a particular food byentering nutritional information about the food into a WWD, transmittingthe same wirelessly to the server, and receiving a recommendation fromthe server. The recommendation may be based on the food and also on dataor information that had previously been transmitted wirelessly,including data from a blood glucose monitor, data input manually, ifany, as well as data from algorithm 63, external data source 74, and AIsystem 76.

Example Employing System for Health Management Using a General ExerciseMachine

Referring to FIG. 6, an example is given for a system of health,nutrition, and/or exercise management. In this example, the HMD is anexercise machine as that termed has been defined above.

The program is started (step 242) and a sensor measures a healthparameter (step 216), where the health parameter corresponds to health,fitness, nutrition, exercise, etc. The sensor may send the parameter tothe exercise machine (step 218). It is understood here that the “sensor”may be, e.g., a blood pressure monitor, but may also be a simple deviceconnected to an aerobic exerciser that tracks miles ran, work performed,etc.

The exercise machine then sends the parameter to the WWD (step 220). TheWWD wirelessly communicates the parameter to the application server(step 222), e.g., via the wireless web.

An alternative and complementary way of entering the parameter is byuser input (step 248). For example, the user may enter the parameterinto the exercise machine or into the WWD. This parameter may correspondto an amount of exercise performed, an amount of food consumed, etc.

Calculations by the application server may also take into accountsupplemental data sent by the user to the server, e.g., in a wiredfashion directly over the internet (step 241).

The application server processes the parameter (step 224 and optionallystep 225), and calculates a response (step 226) based at least in parton the parameter. The application server may optionally employ externaldata (step 232) or an AI system (step 234) in the calculation. Theapplication server then sends the response to the WWD (step 228), wherethe response is displayed.

The same definitional statements regarding the terms “response”,“calculate”, “sensor”, etc., as given before, apply in this embodimentas well.

As an optional step, a health specialist may notify the patient orsubject of the response (step 238) after having the same displayed ontheir client computer (step 236). The health specialist may be replacedin this example by an application that may also include an algorithm.

Adaptor Hardware

A description is given below of a particular type of adaptor hardware.As noted above, the adaptor may optionally be used to connect a HMD to aWWD.

In general, a connection is necessary between a HMD 11 and a WWD. Thenature of this connection may vary. For example, the connection may bewired or wireless. For wired systems, the connection may be direct or anadaptor may be employed, either on one or both ends of the direct wiredconnection, to adapt the signal appropriately. In the same way, forwireless systems, the connection may be direct, if both HMD and WWDemploy the same wireless protocol, or an adaptor may be involved tomodify the signal of one or both devices. These connections, all ofwhich are encompassed by the present invention, are discussed in moredetail below.

Referring to FIG. 7, an embodiment of the connection is shown. In thisfigure, a hardware (or “wired”) connection is shown, i.e., an adaptor168, disposed between a HMD 160 and a WWD 162. In most circumstances, itis assumed that the varieties of HMDs will vary more widely than thevarieties of WWDs. Accordingly, HMD 160 will likely have one of avariety of types of connectors for input/output purposes, here shown asa connector 164. Connector 164 mates with a connector 172 of adaptor168. At another point on adaptor 168 is a connector 172′ for connectingto a generic input/output port 164′ on WWD 162. A cable 170 is disposedbetween the two connectors, cable 170 capable of including adaptorcircuitry if desired.

Of course, the use and structure of adaptor 168, between HMD 160 and WWD162, depends on factors such as the prevalence of an industry standardfor such communications. In other words, if the output of HMD 160 isreadily acceptable to WWD 162, then the same may be directly connectedor may be connected via a simple cable, the same basically extendingfrom pin-to-pin. For example, a standard parallel bus or serial cablemay be used if the input/output ports between the HMD and the WWD, whichmay be, e.g., RS323, are compatible. Otherwise, a suitable adaptorcircuit as noted above may be employed. The connection may also be aninput such as a disk drive or other media input for input of data, a USBport or phone jack or other such wired input, again employing an adaptorcircuit if required.

It is noted as exemplary that several of the most prevalent PDA'scurrently employs the Palm® operating system. The same may be connectedto the Internet in a wireless fashion using one of several availablenetworks. In one version of a Palm® device, a in 10-pin RS232 serialport is provided. In this version of the Palm®, port 164′ can be used tocommunicate with HMD 160 and connector 164 via the optional adaptor 168according to the following pin-out: Pin Name Function 1 DTR DataTerminal Ready signal 2 VCC 3.3 Volts 3 RD (in) Receive data 4 RTS (out)Request to send 5 TD (out) Transmit data 6 CTS (in) Clear to send 7 GP1(in) Interrupt line 8 GP2 (in) modem sync 9 unused unused 10 GND signalground

On the other side of optional adaptor 168, i.e., HMD 160, connector 164may vary more widely. It is noted that certain exercise machines areequipped with DB9 or DB25 RS232 serial connectors. In this case, thepin-outs are (for a DB25): Pin Name Function 1 — Protective/shieldedground 2 TD Transmit Data (a.k.a TxD, Tx) 3 RD Receive Data (a.k.a RxD,Rx) 4 RTS Request To Send 5 CTS Clear To Send 6 DSR Data Set Ready 7SGND Signal Ground 8 CD Carrier Detect (a.k.a DCD) Reserved for data settesting Reserved for data set testing Unassigned 12 SDCD SecondaryCarrier Detect 13 SCTS Secondary Clear to send 14 STD Secondary TransmitData 15 DB Transmit Clock (a.k.a TCLK, TxCLK) 16 SRD Secondary ReceiveData 17 DD Receive Clock (a.k.a. RCLK) 18 LL Local Loopback 19 SRTSSecondary Request to Send 20 DTR Data Terminal Ready 21 RL/SQ SignalQuality Detector/Remote loopback 22 RI Ring Indicator (DCE raises whenincoming call detected used for auto answer applications) 23 CH/CISignal Rate selector 24 DA Auxiliary Clock (a.k.a. ACLK) Unassigned

A connection may simply be made by providing optional adaptor 168 withadaptor circuitry, such as within cable 170 or within a circuit boxtherein, so as to match up the appropriate or complementary pins.

In other embodiments, such as for devices connected to proprietaryconnectors, a less standard and perhaps proprietary pin-out may berequired.

Referring to FIG. 8, an embodiment of a wireless implementation of theWHMA 10 is shown. In FIG. 8, a wireless connection is shown between HMD160 and WWD 162. HMD 160 may have an integral wirelessmodulator/demodulator disposed within (not shown). More likely, however,is that HMD 160 has an adaptor 154 connectable thereto which performsthese functions. Adaptor 154 may plug into a connector 165 on HMD 160.WWD 162 may have an integral wireless modulator/demodulator (not shown),although an adaptor can also be used in this context. If an adaptor isused, the same may plug into generic input/output port 164′.

While the device shown in FIG. 8 is described in the context of generalwireless communications, various protocols may be employed. For radiofrequency communications, protocols such as Bluetooth® or 802.11 may beadvantageously employed. Other techniques employing a similarconfiguration include those employing IR, microwaves, optical techniquesincluding lasers, and so on.

It should be understood that the above is merely exemplary, and that theform of the adaptor may vary widely between HMDs and WWDs.

It will be understood that the above description of a “Method andApparatus for Health and Disease Management Combining Patient DataMonitoring with Wireless Internet Connectivity” has been with respect toparticular embodiments of the invention. While this description is fullycapable of attaining the objects of the invention, it is understood thatthe same is merely representative of the broad scope of the inventionenvisioned, and that numerous variations of the above embodiments may beknown or may become known or are obvious or may become obvious to one ofordinary skill in the art, and these variations are fully within thebroad scope of the invention. For example, while certain wirelesstechnologies have been described herein, other such wirelesstechnologies may also be employed. Furthermore, while various types ofmedical devices have been mentioned, numerous other types may also beused in the embodiments of the invention, including pulse oximeters,syringe drivers, infusion pumps, spirometers, ventilators, anesthesiamonitors, and so on. Accordingly, the scope of the invention is to belimited only by the claims appended hereto, and equivalents thereof. Inthese claims, a reference to an element in the singular is not intendedto mean “one and only one” unless explicitly stated. Rather, the same isintended to mean “one or more”. All structural and functionalequivalents to the elements of the above-described preferred embodimentthat are known or later come to be known to those of ordinary skill inthe art are expressly incorporated herein by reference and are intendedto be encompassed by the present claims. Moreover, it is not necessaryfor a device or method to address each and every problem sought to besolved by the present invention, for it to be encompassed by the presentclaims. Furthermore, no element, component, or method step in thepresent invention is intended to be dedicated to the public regardlessof whether the element, component, or method step is explicitly recitedin the claims. No claim element herein is to be construed under theprovisions of 35 U.S.C. §§112, 6, unless the element is expresslyrecited using the phrase “means for”.

1. A wireless health-monitoring system for monitoring a disease state orcondition of a patient, comprising: an internet-enabled wireless webdevice, the internet-enabled wireless web device including a firstcommunications port having a generic input/output port and a secondcommunications port having a circuit for wireless communications with anetwork, the internet-enabled wireless web device configured to store: ahealth parameter, the health parameter corresponding to a disease stateor condition of a patient and determined by a health parameterdetermining means: a device application; and a user interface; and aserver application, residing on a computer readable medium and disposedon a server in communication with the wireless network, for causing theserver to: receive the determined health parameter; calculate a responsebased in part on the determined health parameter; and provide theresponse to the internet-enabled wireless web device.
 2. The system ofclaim 1, wherein the generic input/output port includes a port forwireless communications.
 3. The system of claim 2, wherein a wirelesscommunications scheme employed by the generic input/output port usesradio frequency.
 4. The system of claim 3, wherein the wirelesscommunications scheme employed uses the Bluetooth protocol.
 5. Thesystem of claim 3, wherein the wireless communications scheme employeduses the 802.11 protocol.
 6. The system of claim 2, wherein the wirelesscommunications scheme employed uses infrared.
 7. The system of claim 1,wherein the generic input/output port includes a port for serialcommunications.
 8. The system of claim 1, wherein the genericinput/output port includes a port for parallel communications.
 9. Thesystem of claim 1, wherein the internet-enabled wireless web device isselected from the group consisting of: an internet-enabled cellularphone; a handheld, palm, or laptop computer having an optionalimplemented or integral wireless capability; and a hybrid device of ahandheld computer and cellular telephone.
 10. The system of claim 9,wherein the internet-enabled wireless web device is a personal digitalassistant with a wireless capability.
 11. The system of claim 1, furthercomprising a medical device, the medical device including the healthparameter determining means, the medical device further comprising anoutput port to deliver data corresponding to the health parameter. 12.The system of claim 11, further comprising an adaptor for connection tothe output port of the medical device, the adaptor having an output todeliver data corresponding to the health parameter.
 13. The system ofclaim 12, wherein the adaptor output and the generic input/output portcommunicate via a wired link.
 14. The system of claim 12, wherein theadaptor output and the generic input/output port communicate via awireless link.
 15. The system of claim 14, wherein a wirelesscommunications scheme employed by the generic input/output port and theadaptor output uses radio frequency.
 16. The system of claim 15, whereinthe wireless communications scheme employed uses the Bluetooth protocolor the 802.11 protocol.
 17. The system of claim 14, wherein a wirelesscommunications scheme employed by the generic input/output port and theadaptor output uses infrared.
 18. The system of claim 11, wherein theoutput port of the medical device and the generic input/output portcommunicate via a wired link.
 19. The system of claim 11, wherein theoutput port of the medical device and the generic input/output portcommunicate via a wireless link.
 20. The system of claim 19, wherein awireless communications scheme employed by the generic input/output portand the output of the medical device uses radio frequency. 21-105.(canceled)